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Home My WebLink AboutPermit Building 1991-09-17SPRINGFIELE) R[3ID=NTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 LOCATION OF PROPOSED WORK: ASSESSORS MAP:l'?-02.- icl-33-3 oo LOT:BLOCK TAX LOT: SUBDIVISION ZIP:Cr.STATE: PHONE: < t Ud.r,2.* l'rrr raac 7*b241^-7'7o- -1/oV 9tqtCITY: ADDRESS OWNER A'r EMO i R DESCRIBE WO\.emad € I NEW e \a' DEL X ADDITION X DEMOLISH OTHER ELECTRICAL: EXPIRES PHONE S S e.st-\A< PLUMBING MECHANICAL: ADDRESSCONTRACTOR'S NAME CONST. CONTRACTOR # ,. GENERAL: WATER HEATER:RANGE: # OF BDRMS ""ii'(\ - ZONING CODE: FLOOD PLAIN * OF UNITS: SECONDARY HEA-N SQUARE FOOTAGE: LAND USE: OCCY GROUP: # OF STORIES QUAD AREA: * OF BLDGS: CONSTR. TYPE HEAT SOURCE: To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:OO a.m. will be made the following work day. REQUIRED INSPECTIONS l-l Temporary Electric m Rough Mechanical - Prior to cover. [-X Final PlumbingL.- plumbing work - When all is complete. Site lnspection - To be made after excavation, but prior to setting forms. d Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover Underslab Plumbing/ Electrical / Mechanical - Prior to cover.Electrical Service - Must be approved to obtain permanent electrical power. E Final Mechanical - When all mechanical work is complete. w Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsp. tr Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.a w Framing - Prior to cover.a Foundation - After forms are erected but prior to concrete placement. Other Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.B orv*un - Prior to taping MOBILE HOME INSPECTIONSUnderf loor Plumbing / Mechanical - Prior to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decki ng.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Water Line - Prior to filling trench.l-_l Fence - When compteted Streel Trees - When all required trees are planted. Final - After all required inspections are approved andporches, skirting, decks, and venting have been installed. ffi Rough Plumbing - Prior to - cover. E tl PL.HSE GAR ACC N f,oP' S sA (?/' t1', E 'Ao' Lot faces -5 Lot sq. rts. 212d, Lot coverage Topography rotar heisht AA! Lot Type X lnterior - Corner - Panhandle - Cul-de-sac Setbacks IS THE PROPOSED WORK IN ]HE--". HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? A,I<) lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: BUILDING PERMIT ITEM SQ. FT./SQ. FT.VALUE Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee q2. f,a a6V (A)?7.13 BUILDING VALUE, PLAN CHECK AND BUlLDlNG PERMIT This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Spri ngfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any o said ordinances. Plan Check Fee: Date Paid Receipt Numbe Received By: 7 ?r Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. PLUMBING PERMIT ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE 42-* N0 FT. FT. FT. Plumbing Permit State Surcharge Total Charge 40.n - 4c' (c)/2.n ADDITIONAL COMMENTS MECHANICAL PERMIT Furnace Exhaust Hood ?.4?6.*Vent Fan N, ZX7 Wood Stovei lnsert/Fireplace Unit Dryer Vent 2,4 Mechanical Permit ,Vttr- /C-'o /?-e lssuance State Surcharge Total Permit / -?u (D)^4.2f By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the I times during construction Sig Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut .-- ft Demolition State Surcharge Total Miscellaneous Permits (E) VALIDATION RECEIPT NUMB DATE PAID AMOUNT RECEI RECEIVED BY ED TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) /4f B 3Cr' 4 ,CITY onEGolv 225 FIFTH STRBET SPRINGFTELD, OREGON 97477 INSPBCTION REQUBST: 726-3769 OPPICE: 726-3759 1. LOCATION OF INSTALLATION Ve^ /ano/'f To . I,BGAL DBSCRIPTION JOB DBSCN.IPTION Permlts are non-transferable and expirelf vork is not started vithln 180 daysof issuance or if vork is suspended for 180 days. 2. COI'mRACf,OR INSTATI,ATION ONLY Electrical Contractor Address ci Phone Supervisor License Number Expiration Date Constr Contr. Number -.'tutt(;FtI:Lr, BI,BCIRICAL PBRT{IT APPLICATION 3. COHPI,BTE FBB SCEBDUI,E BBLOS A. Nev Residentlal-Single or Multl-Family per dvelling unlt. Service Included: I tems c 1000 sq.ft. or less Each addltlonal 500 sq. ft or portion thereof Each Manuf 'd llome or Modular Dwelllng Service or Feeder Cos t $ 8s.00 $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less I 201 amps to 400 amps _401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only Temporary Services or Feeders Installatlon, Alteration or Relocation D. Branch Circults SUBTOTAL OT ABOVB 5Z State Surcharge TOTAL B Sum ZN$ s0. $ 60. $100. $130. $300 $40 00 00 00 00 00 00 Exp 200 amps or less $ 40.00 201 amps to 400 amps _ $ 55.00 0ver 600 amps or 1000 volts see rrBfr above Signature of Supervlslng Blectrlcian Owners Name Address {,futF . iration Date Ct ty OIINER INSTALI..ATION The lnstallation is being made on property I own which is not intended for sale, Iease or rent. Signature: Nev, Alteration or Extension Per Pane1 one Circuit t/' $ 35.00 7E*Each Additional Circuit or vith Service or Feeder Permi I ? $2.90 6. * E. Miscellaneous (Service/feeder not included) -Bach installation Ptrmp or irrigation signZouttine Lighting- Limited Energy/Res Limited Energy/Comm - f4ffi.z4Yo V^776-re ne /l-"?b4//7 $ 40.00 $ 40.00 $ 20.00 $ 36.00 RECEIVBD BY: 5 e /2 -A-/a?? tzz>-aa City Job nu b". ? /d??3 Permit No: Address: lssued Date STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants yvho are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box '1 and either box 2A or zBl. 1 I own, reside in, or will reside in the completed structure 2. A. l-l My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B I will be my own general contractor. lf ! hire subcontractors, I will hire only subcontractors reoistered with theConstruction Contractors Board. lf I chanoe my mind and Eo hire a oensralcontractor, !will contract with a contrattor-who is reoistered witn theConstruction Contractors Board and I will immediatelv-notifv the officeissuing this building permit of the name of the contraitor. ' I hereby certify that the above information is correct and that I have read and understandthe lnformation Notice to Property Owners about Construction Responsibilities on thereverse side of this form. Q- t7- q/ ure CONSTRUCTION @NTRACTORS BOARD 02M) 10t24ts, Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT @s